Early-Pregnancy Vitamin D Deficiency and Risk of Preterm Birth Subtypes

Details

• Alternative Title:
  Obstet Gynecol
• Personal Author:
  Bodnar, Lisa M. ; Platt, Robert W. ; Simhan, Hyagriv N.
• Description:
  Objective
  
  To estimate the association between maternal hydroxyvitamin D (25-hydroxyvitamin D) concentrations and risk of preterm birth subtypes.
  
  Methods
  
  We performed a case-cohort study using data and banked samples from patients at a teaching hospital in Pittsburgh, Pennsylvania. Eligible participants were women with a prenatal aneuploidy screening serum sample at or before 20 weeks of gestation who subsequently delivered a singleton, live-born infant. Of the n=12,861 eligible women, we selected n=2327 at random as well as all remaining preterm birth cases for a total of n=1126 cases. Serum 25-hydroxyvitamin D was measured using liquid chromatography–tandem mass spectrometry. Multivariable log-binomial regression models were used to estimate associations between maternal vitamin D status and preterm birth <37 weeks (separately by spontaneous or indicated) and preterm birth <34 weeks.
  
  Results
  
  The incidence of preterm birth <37 weeks was 8.6% overall and 11.3%, 8.6%, and 7.3% among mothers with serum 25-hydroxyvitamin D<50, 50–74.9, and ≥75nmol/L, respectively (p<0.01). After adjustment for maternal race and ethnicity, prepregnancy BMI, season, smoking, and other confounders, the risk of preterm birth <37 weeks significantly decreased as 25-hydroxyvitamin D increased to approximately 90 nmol/L and then plateaued (test of nonlinearity p<0.01). Results were similar when limiting to cases that were medically indicated or occurred spontaneously and cases occurring at <34 weeks of gestation.
  
  Conclusions
  
  Our data support a protective association maternal vitamin D sufficiency and preterm birth that combined with extant epidemiologic data may provide justification for a randomized clinical trial of maternal vitamin D replacement or supplementation to prevent preterm birth.
  
  
• Subjects:
  Adult Case-Control Studies Cohort Studies Female Humans Incidence Pennsylvania Pregnancy Premature Birth Prevalence Vitamin D Vitamin D Deficiency Young Adult

  More +
• Source:
  Obstet Gynecol. 125(2):439-447
• Pubmed ID:
  25569002
• Pubmed Central ID:
  PMC4304969
• Document Type:
  Journal Article
• Funding:
  R01 HD056999/HD/NICHD NIH HHSUnited States/ ; U01 DP003177/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  125
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:b5e07c71fb493f87b4f0a4d628fe952ddad09757fcffec52a71ab765d1af948e
• Download URL:
  https://stacks.cdc.gov/view/cdc/30259/cdc_30259_DS1.pdf
• File Type:
  [PDF - 800.39 KB ]